Best Diet for Prediabetes and High Blood Pressure

What is the Best Diet for Prediabetes and High Blood Pressure?

As a registered dietitian, I often see people who have both prediabetes and high blood pressure. So, the obvious question is “what’s the best diet for managing both prediabetes and high blood pressure?” Is there a diet that can help both? 

Yes. There are a variety of dietary patterns that can help improve both prediabetes and high blood pressure. However, the DASH Diet is the one that has the most research behind it for both prediabetes and high blood pressure. 

Now, does that mean the DASH diet is the only diet that can improve blood pressure and prediabetes? Absolutely not.

But, my goal in this blog post is to: 

  • Explain what the DASH Diet consists of
  • Help you understand why it’s beneficial for both prediabetes and high blood pressure
  • Help you apply some of those components to your own diet

Sound good? Let’s dive in, and start by defining what the DASH Diet is. 

The DASH Diet: What is it?

The DASH Diet is one of the most well-researched diets that actually was specifically designed to help lower blood pressure. And, that’s why it’s called the DASH Diet, because DASH stands for Dietary Approaches to Stop Hypertension. 

This is a diet rich in fruits, vegetables, and whole grains while also including lean protein sources, and low-fat dairy products.

There are some foods that it also recommends limiting, such as foods high in saturated fat, sugar, and sodium. 

Even though the DASH diet was originally designed for people with high blood pressure, studies have shown that it can also be effective for improving insulin sensitivity, reducing inflammation, and lowering blood sugar levels in those with diabetes and prediabetes.

For example, a 2014 review concluded that several dietary patterns, including the DASH Diet and the Mediterranean Diet were associated with a 20% reduced rate of developing type-2 diabetes. 

What Does the DASH Diet Consist of?

For most people, it’s no big surprise that a “healthy” diet consists of fruit, vegetables, and whole grains. You’ve probably heard this kind of advice repeated ad nauseam. 

In those terms, the DASH Diet is not going to blow your mind. It should sound fairly familiar, but too often we just gloss over these recommendations, rather than digging into the details to see how we can apply them. And, as they say, the difference is in the details. 

So, rather than shaking your head, “yeah, yeah, yeah – I get it, eat more fruit, veggies, and whole grains”, let’s dive into the details and pull the DASH Diet apart piece by piece, so you can better apply it to your own diet.

As we go through the details, I recommend you do the following:

  1. Make note of 2-3 areas where you think you could most easily improve
  2. Write down a goal for yourself for each one of these areas (make it easy and doable)
  3. Over the course of the next week, focus on achieving just one of those goals

Fruits and Vegetables

The DASH diet recommends 4-5 servings of fruits and 4-5 servings of vegetables per day. Both are rich in vitamins, minerals, fiber, and antioxidants, which can all help lower blood pressure and improve insulin sensitivity. In particular, the mineral balance between potassium, calcium and magnesium can be beneficial for regulating blood pressure.

But, here’s the obvious question – what does 1 serving of fruit or vegetables look like?

For veggies, one serving is:

  • 1 cup of raw leafy greens
  • ½ cup of chopped raw veggies, or cooked veggies

For Fruit: 

  • 1 medium fruit
  • ½ cup of cut fruit, or frozen fruit

To make things even more simple, envision a tennis ball. That is about the size of 1 cup. So, aim for 4-5 tennis balls of fruit, and 4-5 tennis balls of veggies per day.

serving of fruit

Does Juice Count? 

In my opinion, juice does not count toward any of your fruit or vegetable servings. It’s okay to have it in moderation, but don’t convince yourself that you’re eating a healthy diet because you have fruit in the form of juice daily. 

One of the primary benefits of eating fruits and vegetables is the fiber they both contain. When you juice them, you remove the fiber, which is not ideal for balancing your blood sugars. 

Want some healthy alternatives? Check out these 7 Drinks for High Blood Pressure.

Whole Grains

The DASH diet recommends consuming 6 to 8 servings of whole grains per day. Whole grains are also a good source of fiber, which can blunt the post meal rise in blood sugar levels, help prevent overeating, and can even lower cholesterol levels.

What comes to mind when you think of whole grains? For most people, they think of packaged meals that are labeled as “whole grain”, like whole wheat bread, or whole grain pasta noodles. But, the “whole grain” label can be deceiving. 

In order to label a food as “whole grain”, only 50% of the grain has to be whole grain. So, that whole wheat bread, technically isn’t whole wheat, it just has some whole wheat in it. Crazy, right?

That’s why I recommend pushing your boundaries with whole grains and trying some of the following, listed below. 

Examples of whole grains:

  • Old Fashioned Oats (check out overnight oats for an easy breakfast option)
  • Quinoa
  • Barley
  • Farro
  • Buckwheat
  • Brown rice

A serving of whole grains is equivalent to about half a cup, or ½ of a tennis ball. 1 cupped handful. So, you should be aiming for about 6-8 cupped handfuls, or 2-3 tennis balls per day.

handful of whole grain

Lean Meat

The DASH diet limits fatty red meats such as beef, pork and lamb. That’s because these meats tend to be higher in saturated fat which is linked to increased LDL cholesterol, which is then associated with heart disease. In general, saturated fat intake also has a tendency to increase overall calorie intake, which can lead to weight gain. 

Instead, the DASH diet recommends lean meat sources such as fish and poultry, and additional protein can also be obtained through nuts and seeds.

You should aim for about 2 servings of lean meat per day, and one serving is the equivalent of 3 ounces. You can visualize that as the size of a deck of cards, or the palm of your hand. So, limit yourself to 2 decks of cards worth of lean meats per day.

Nuts, seeds, and legumes

The DASH diet recommends consuming 4 to 5 servings of nuts, seeds, and legumes per week. These foods are a good source of protein, fiber, and healthy fats like omega-3, which help reduce inflammation. 

A serving of nuts/seeds is considered ¼ cup, which is equivalent to about 1 golf ball.

For nuts, choose from: 

  • Walnuts
  • Almonds
  • Cashews
  • Pecans
  • Peanuts

Seeds can include:

  • Flax
  • Pumpkin seeds
  • Chia seeds
  • Sunflower seeds
  • Sesame seeds

Many of these are best mixed into other foods. For example, chia and pumpkin seeds can be good additions to this overnight oatmeal recipe. The important thing to remember when buying nuts and seeds is to get unsalted options, or they can actually increase your blood pressure because of the excess sodium. 

½  cup of beans and lentils are considered a serving, and can include:

  • Garbanzo beans
  • Pinto beans
  • Black beans
  • Kidney beans
  • Lima beans
  • Fava Beans
  • Brown, green, red, or yellow lentils

Dried beans and lentils are preferred because they tend to be lower in salt than canned prepared options. But, if you don’t have time to cook them at home, you can choose the “low sodium” or “no salt added” canned options.

One half a cup of beans is the equivalent of about 1 fist.

So, you’ll want to aim for a combo of 3 golf balls of nuts and seeds and 3 fist fulls of beans and lentils per week.

Low-Fat Dairy

The DASH diet recommends consuming 2 to 3 servings of low-fat dairy products per day, such as skim milk, yogurt, and cheese. I recommend including greek yogurt as it’s a good source of protein, and also contains naturally occurring probiotics which can help aid digestion.

1 serving of dairy is about 1 cup of milk (1 fist), ¾ cup yogurt (1 fist) or 2 tbsp of cheese (2 thumbs). 


A key component of the DASH Diet is that it reduces sodium. The diet recommends no more than 2,300 milligrams of sodium per day, which is about 1 teaspoon of salt.

To help reduce sodium intake, but maintain flavor in your food, use herbs and spices such as the following: 

  • Pepper
  • Cumin
  • Paprika
  • Oregano
  • Thyme
  • Cayenne
  • Garlic

The other way to reduce sodium intake is to eat fewer packaged meals. Sodium is used as both a flavor enhancer, and a preservative, so it’s often used for both of those reasons in packaged foods. If purchasing packaged goods, look for foods with less than 140 mg per serving. 

Limited Sugar and Sweets

The DASH diet recommends limiting sugar intake to less than 5 servings per week. One serving is a tablespoon, which is about the size of your thumb. 

If you have a sweet tooth, and you’re struggling to stay within these recommendations, consider replacing your sweets with whole fruit. By doing so you’ll increase your fiber intake, which will make you feel full quicker, thus reducing the overall amount of sugar you consume. 

Summarized DASH Recommendations

Here’s a breakdown of those recommendations above, using the visual cues outlined. 

On a daily basis you should aim to eat:

  • Vegetables: 4-5 fist fulls (or 2-3 palms if chopped veggies)
  • Fruit: 4-5: fist fulls (or 2-3 palms if cut or frozen fruit)
  • Whole grains: 6-8 cupped handfuls (or 2-3 tennis balls)
  • Lean meat: no more than 2 palms worth (or 2 decks of cards)
  • Dairy: 2-3 fists of milk/yogurt, or 2 thumbs of cheese
  • Limit Sodium to less than 2,300 mg (or 1 tsp/thumb)

And, on a weekly basis, eat:

  • Nuts and seeds: 3 golf balls
  • Beans and Lentils: 3 fist fulls 
  • Limit sugar and sweets: No more than 5 thumbs per week

Why Does the DASH Diet Work for Prediabetes?

You may have noticed that the DASH Diet tends to emphasize eating whole foods. When we increase things like whole grains, vegetables and fruit, we tend to automatically increase the amount of fiber in our diet.

Fiber provides several different benefits for both prediabetes and high blood pressure. First of all, it makes us feel full, so we’re likely to eat fewer calories.

Second of all, fiber is not digested and broken into glucose, so it doesn’t cause your blood sugar to rise the way sugar or starch does. Because of that, it helps lower overall blood glucose levels.

It’s also worth recognizing the effect of following a low sodium diet. Sodium does not affect blood sugar levels, but if you’re trying to limit sodium, you’re more likely to also limit processed sugars and grains, because these often contain a lot of sodium. So, by following a low sodium diet, you might automatically limit processed foods or avoid eating out, which can be beneficial for managing blood sugars. 

Need Help With Prediabetes or High Blood Pressure? 

I’m a Registered Dietitian who provides online nutrition counseling to help people reduce their risk for chronic disease. I help my clients understand their risk factors, develop knowledge, set goals, and take action to improve their health. 

If you’re feeling overwhelmed with the nutrition and health information you’re finding online, and looking for some help to get control of your health, please reach out. I’d love to help you ditch the diet confusion, and make healthy changes that last for the long haul. 

You can learn more about my services here, and reach out for a 20-minute consultation call here.

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